Provider Demographics
NPI:1629675368
Name:HAIDER, AMNA ABDULAZIZ
Entity Type:Individual
Prefix:
First Name:AMNA
Middle Name:ABDULAZIZ
Last Name:HAIDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HOWE AVE
Mailing Address - Street 2:
Mailing Address - City:MILLBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01527
Mailing Address - Country:US
Mailing Address - Phone:508-865-2085
Mailing Address - Fax:508-865-2101
Practice Address - Street 1:50 HOWE AVE
Practice Address - Street 2:
Practice Address - City:MILLBURY
Practice Address - State:MA
Practice Address - Zip Code:01527
Practice Address - Country:US
Practice Address - Phone:508-865-2085
Practice Address - Fax:508-865-2101
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health